Hepatitis Outbreak Spurs Inoculations in 5 States

Education and health officials in five states inoculated thousands
of students and school staff members last week after investigations
revealed that frozen strawberries served in school lunches came from
the same lot that spurred an outbreak of hepatitis A in Michigan
schools.

U.S. Department of Agriculture officials announced earlier this
month that a batch of tainted strawberries responsible for more than
150 cases of hepatitis A among students and school workers in Michigan
had been dispatched to schools in Arizona, California, Georgia, Iowa,
and Tennessee as part of the agency's school lunch program.

To offset a situation that could have led to widespread panic among
parents and students, state health departments and school districts
quickly set up emergency hepatitis A hot lines and spread the word
through local newspapers and fliers about where and when to get
children inoculated.

Officials in Georgia mounted a mass inoculation campaign last week,
administering more than 5,000 gamma-globulin injections to students and
school personnel who may have consumed the tainted strawberries.

In an elementary school in Camden County, Ga., 250
students--three-fourths of the student body--who ate strawberry fruit
cups at the end of March lined up for their injections last week.

Camden school officials had to act quickly because gamma globulin is
only effective for 14 days after exposure and the entire district was
on spring break the previous week.

"It was difficult because people were spread hither and yon because
of the holiday," said Ann Proctor, the associate superintendent of the
9,000-student district. "Fortunately, it worked out time-wise."

Officials in the Los Angeles school district also promptly responded
to the potential health crisis and issued shots to 8,400 students and
staff members in 17 schools who may have been exposed to the virus
after eating the fruit cups in their midday meals.

"Its been running amazingly smoothly," said Pat Spencer, a spokesman
for California's largest, and only, district to receive the
questionable fruit.

California health department officials estimate the total cost of
the 9,000 shots at about $30,000.

Andrew & Williamson, the San Diego packing company that supplied
the berries, said last week that it would pick up the tab for all
inoculations related to the outbreak. So far, the federal Centers for
Disease Control and Prevention has delivered 30,000 doses of gamma
globulin to schools across the country.

Knock on Wood

While states like California and Georgia rushed to immunize their
school populations, other states decided against a widespread
vaccination campaign. Iowa health officials determined that the risk of
infection was too low and the potential risks serious enough to avoid a
massive public health response.

"Anytime you do an inoculation, there's a very slight risk from
complications, so we didn't want to do it here," Kevin Teale, the
spokesman for the Iowa health department, said. About 100 schools in
Iowa served the suspect berries to students in January. No one has
become sick yet. The CDC says that individuals with hepatitis A often
begin to show symptoms of nausea, fatigue, and loss of appetite within
three to six weeks. "Right now, it's fingers crossed, knock on wood,"
Mr. Teale said.

Many school officials are still waiting for government assurances on
the integrity of the school meals program. "We'll be interested in
hearing what kinds of guarantees we can expect on [the USDA's] other
products," said Mr. Spencer. USDA and CDC officials are trying to
pinpoint where the virus might have entered the school food supply. The
infection is spread orally or through human waste, often by people with
poor hygiene who handle food.

Contamination could have occurred in the growing, storing, or
packing of the product that was shipped from Mexico to the California
producer, CDC officials said. They have ruled out school-based food
handlers as the contamination source.